Medical insurance problems

My wife Noel and I currently do not have Health insurance. Following is our dilemma.

In March of 2008 we purchased a home in Arizona and gave up our full time RV lifestyle. We had been residents of Washington State and had health insurance through LifeWise of WA. A nice provision of this arrangement was that they shared coverage in AZ through LifeWise of AZ, so we were covered in both places with in-plan providers. Since LifeWise of WA does not cover Arizona residents, we were forced to change our coverage and thought it would be a simple paperwork process to move to LifeWise of AZ. I finally got around to making the request for the switch in May. To our surprise, we were denied coverage and a new term of COPD came into our vocabulary.

We had to look it up on the Internet to discover that it is Chronic obstructive pulmonary disease, a serious lung condition, often associated with Emphysema and chronic bronchitis. The symptoms are:
  • Cough with mucus
  • Shortness of breath (dyspnea) that gets worse with mild activity
  • Fatigue
  • Frequent respiratory infections
  • Wheezing


    • None of these symptoms are exhibited by Noel.
    Of course I immediately contacted the insurance company to find out what this was about, since Noel was fairly healthy and we could not recollect any mention of this new term. They said it was based on a doctor's review of the insurance charges for lab work done on 2/14/07.

    So thus begins a review of history as to what happened a year before. In February of 2007, we were in Tucson as we lived in our RV full time. Noel had been having some sinus problems which seemed like allergies and wanted to visit a doctor to find some relief. She went to the Courtney Medical Group in North Tucson as she had felt comfortable with Susan Courtney in previous visits. An exam was performed and lab tests ordered by a Nurse practitioner, Janet Weber, since Susan was out of town. Noel went to the laboratory on 2/14/07 and had blood drawn that are used to test for Glucose Tolerance and Hemoglobin (for diabetes). On 2/15/07, the results came back to the doctor's office and the nurse practitioner scribbled a bunch of stuff on her report, which to us was mostly unintelligible and meaningless.
         
    However, the text in the bottom left corner of the nurse's report had the 4 letters COPD which is now the knife through the heart for our insurance requests. It actually looks like "COPD - up to date exam", not a diagnosis that she indeed has COPD, but that it was investigated. When the insurance customer service representative specified that the insurance pay out for the lab test used for that report was the key element, I had her explain what those lab tests are and what they determine. They were indifferent to the fact that you can not determine COPD with a blood test, but must use lung function tests and X-rays. The insurance company said that we would need to contact our doctor to straighten this out.

    When we called the doctor's office, to our surprise, they were most uncooperative. Since the insurance request review took some time, our WA insurance had been terminated. So now that we were with no insurance, we were told that we were no longer a patient of Courtney Medical Group since they only accept insured clients. "Click", we were hung up on. Each time we tried to call to request a review and clarification of this damning report, we were hung up on. We could never get past the receptionist to talk to anyone with a medical background.

    Most people tell us that all we have to do is get a new checkup to prove that COPD does not exist. However, this was not Noel's only visit to Courtney. On 4/25/08 she had X-rays ordered by the Courtney Medical Group (while we were still unaware of the lurking COPD bomb) where the radiologist states "Lung fields are well aerated and clear" and also "NO SIGNIFICANT INTERIM CHANGE SINCE 11-8-06"

    So obviously she had X-rays both before and after the 2007 blood test, that demonstrate that her lungs are just fine. But since the COPD remains on the blood test review, the insurance company refuses to use common sense and realize that she could not possibly have COPD.

    I can be reached at